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Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2012-20, 2013 Jan; :1-13

On January 9, 2012, a 63-year-old male volunteer fire fighter ("the FF") was dispatched at 0633 hours to a motor vehicle crash involving three vehicles with possible entrapment. At the scene, the FF operated the pumper as crew members utilized a handline to wash the fuel away from the vehicles. A short while later the Chief found the FF collapsed on the elevated pump platform. Crew members pulled the FF from the pumper to the ground, assessed him, and found him to be unresponsive, not breathing, and without a pulse. An ambulance was requested as cardiopulmonary resuscitation (CPR) was begun (0705 hours). A paramedic ambulance arrived 15 minutes later and began advanced life support. The FF was transported to the local hospital's emergency department (ED) arriving at 0749 hours. Inside the ED, cardiac resuscitation efforts continued for an additional 6 minutes when the FF was pronounced dead. The death certificate, completed by the county coroner, listed "acute myocardial infarction due to thrombosis of the left main coronary artery due to atherosclerotic coronary artery disease with cardiomegaly (830) grams" as the cause of death. The autopsy report, completed by a pathologist, listed "acute myocardial infarction" as the cause of death and "strenuous activity during rescue procedures" as a contributing factor. Given the FF's history of underlying coronary heart disease (CHD), NIOSH investigators concluded that the physical stress of responding to the call and performing driver/operator duties triggered his heart attack and subsequent sudden cardiac death. NIOSH investigators offer the following recommendations to address safety and health issues and prevent similar incidents in the future. 1. Provide preplacement medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 3. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 4. Perform an annual physical performance (physical ability) evaluation for all members.